Publication:

Total laparoscopic hysterectomy versus vaginal hysterectomy: a retrospective study

Background Total laparoscopic hysterectomy (TLH) is now emerging as a safe procedure even in patients suitable for vaginal hysterectomy (VH) due to its advantages like better visualisation, less post-operative pain and shorter hospital stay. This study was done to compare the duration of surgery, intra-operative and postoperative complications, hospital stay and post-operative analgesia requirement in TLH and VH.

Methods A retrospective study of women undergoing TLH and VH between June 2013 and September 2014 in JSS Hospital, Mysore was done. Patients with suspected genital malignancy and uterine prolapse were excluded. Baseline characteristics like age, BMI, parity, indication for hysterectomy, uterine size and previous pelvic surgeries were noted. Intra-operative and post-operative parameters like duration of surgery, complications, post-operative analgesic dosage and hospital stay were compared between the two surgeries and the results were analysed using Chi square test and independent t test.

Results The mean time taken to perform TLH was significantly longer, i.e. 113.46 minutes compared with VH, i.e. 61.18 minutes ( p <0.0001). But the duration of stay in the hospital was shorter for the women undergoing TLH, mean duration being 3.74 days as opposed to 5.85 days in women undergoing VH  (p<0.0001). Also, women undergoing VH required more analgesic doses (mean 1.79) than those undergoing TLH (mean 1.36). When we studied the rate of complications in both the groups, we found no statistically significant difference.

Conclusions TLH was as safe as VH and had advantages like shorter hospital stay and reduced analgesia dose.